We present here of the cervical lymphadenopathy in a-42-year old female. Two suspected lymph nodes were surgically removed of which larger one measured 3.2x1.8 cm while another measured 1x0.4 cm.  
Microscopically, a preserved germ centers with enlarged marginal zones of the follicles were a dominant feature. Lymphocytes in marginal zones were of monocytoid appearance with their progagation into interfollicular areas which contained proliferating blood vessels with some plasma cells and eosinophils.  
Immunohistochemistry: CD20(+), Bcl-2(positive in interfollicular and marginal zone), CD3(sporadically positive in interfollicular areas), IgD(+), IgG(-/+), CD43(-), CD5(-).  
Clinical diagnosis: No  
Histopathological diagnosis: Marginal zone lymphoma?  
Please, give your opinion.

Mueller-Hermelink 2008-01-06 17:36	The most probable diagnosis would be reactive lymphadenopathy with follicular hyperplasia and early progressive germinal center transformation. However, in these instances I have seen several times a so-called Mantle cell lymphoma in situ , which should be excluded by CD5 and CND1 staining.
anpo 2008-01-06 19:50	I agree, by morphology it looks reactive, but cyclin D1 should be done to be on the safe side.
nurija 2008-01-06 22:50	The stain for CD5 highlights only the few paracortical T cells present, and the stain for CD10 highlights only the germinal center cells. Also, an immunostain for bcl-2 is positive on the monomorphous population of lymphocytes and is negative in the germinal centers.   Tomorrow we will add to the few new images.
semir 2008-01-09 23:11	More figures added in order to clarify this lesion.
hurwitz 2008-01-10 16:58	I agree, morphology and immunohistochemistry strongly favour reactive follicular and interfollicular hyperplasia. The question is, if PCR for IgH rearrangenet should be performed to be on the safe side.
Mueller-Hermelink 2008-01-11 20:51	The CD5 stain is very convincing : I would sign out as freactive hyperplasia.
hurwitz 2008-01-16 19:06	Thank you Dr.Müller Hermelink, your statement is the final one.   Thanks also to Semir, Nurja and Anja.
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